When You're Already High
A scene from Neil's actual life: an airport layover, a stubborn high from hours of travel sitting, and one man doing laps past the same Cinnabon so many times the employees start whispering. This episode covers movement as a tool when your blood sugar is already high...
The episode, word for word
Here's a scene from my actual life. I'm at an airport, mid-layover. My CGM has been parked at a number I don't love for two hours, because travel days are just the chair tax with worse snacks. Plane seat, terminal chair, plane seat again. So I do the thing I always do. Audiobook in. Carry-on handle in hand. And I just walk the terminal. Gate A to gate F and back. Over and over. One man and his rolling luggage, passing the same Cinnabon so many times the employees start giving each other looks like, "Is he casing the place? Should we call somebody? He's been by nine times."
I'm not casing the place, people. I'm doing diabetes.
That's today's episode: movement as a tool when you're already high. What it can do, what it can't, and the one rule that never bends.
I'm Neil Greathouse, this is Your Best T1D Year.
Why does the layover walk work? It's everything we learned this month, pointed at a high. The side door opens, remember, your muscles pulling sugar out of the blood, no extra insulin needed, and whatever correction you've got on board suddenly gets help. Walking doesn't replace insulin, hear that part clearly. It just helps the insulin you already took do its job. And on a travel day, when my sensitivity is in the basement from all that sitting, that's often the difference between a high that drifts down nicely and a high that just squats there all afternoon like it pays rent. It does not pay rent. It has never once paid rent.
NOW. The rule. And I will repeat this rule every single time this topic comes up, from now until forever, because it matters that much.
If you're high, check for ketones before you use movement as a tool. If ketones are present? Movement is OFF the table. Full stop. Done. High plus ketones means your body needs insulin, fluids, rest, and probably a call to your care team, and exercise can make that situation genuinely worse. No walk is worth it. Say it with me, out loud, I don't care if you're in your car: high and no ketones, gentle movement can help. High WITH ketones, the walk is cancelled. That rule doesn't bend. That's straight from the exercise consensus, and it's the one thing in this whole challenge I need you to know cold.
The other honest caveats, quickly. It's a nudge, not a correction. Expect help, not miracles. Keep it easy, because hard exercise while high can actually push things the wrong way. And if you've got stubborn, repeating highs? That's a pattern conversation for your care team, not something to out-walk. You cannot out-walk a basal problem, people. Believe me. The Cinnabon employees watched me try.
And... that's September. Month one, done. Count what you're carrying out of it: the chair is the villain. The side door. The two-day bonus. Three walks beat one. The movement snack, with the ADA's stamp on it. The after-dinner ten. The safety net. And now the ketone rule. That is a real education, and you got it in ten-minute chunks while walking your dog.
October? We take all of it into real life. The desk-job playbook. Movement when walking isn't an option, and I mean really isn't an option, that episode's important. The weather turning. And making this whole thing stick past Halloween, which, yes, there will be a Halloween episode, and yes, I'm way too excited about it.
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Your challenge this weekend: keep the anchor walk. And if a high shows up and you're ketone-free, try the gentle-walk assist and watch what your line does. No ketones first. Always. You know the rule now.
yourbestt1dyear.com. Newsletter, free tracker, about 2,000 of us. Tell the Cinnabon people I said hi.
Nobody remembers easy. You just did a whole month of not-easy, and I could not be prouder of you.
We are the ones. If you're living with type 1, if you love somebody who has it, if you're a caregiver, if one of your kiddos has it. We are the ones. My name is Neil. See you Monday. October's going to be good.
This is the episode script as read on the mic. It's education and encouragement, not medical advice. Talk to your care team before changing anything about your management.
